Hypospadias Repair

Definition

This surgery is used to treat a condition called
hypospadias
. This condition affects the penis and urethra. The urethra is the tube that connects the bladder to the outside of the body so that urine can exit. With hypospadias, the opening of the urethra develops on the underside of the penis. The goal of surgery is to put the opening of the urethra at the tip of the penis.

Reasons for Procedure

The surgery is done on male children born with hypospadias. Some males will not have problems from hypospadias. In some, the condition may make it difficult for the child to urinate while standing. It may also affect sexual function.

The surgery is typically done at age 3-18 months old. It can also be done in older children and adults. In infants with hypospadias,
circumcision
should not be done. Tissue from the foreskin may be used if surgery is done to correct the hypospadias.

Possible Complications

Complications may occur after hypospadias surgery. The further the opening is from the tip of the penis, the higher the complication rate. If your child is having hypospadias surgery, the doctor will review a list of possible complications, which may include:

A new opening on the underside of the penis called a fistula, causing urine leakage

What to Expect

Prior to Procedure

The doctor may do the following:

Physical exam

Imaging, blood, and urine tests

Discuss the anesthesia being used and the potential risks

Talk to the doctor about your child’s medications and supplements. Your child may need to stop certain medications before the surgery. The doctor may also ask that your child take certain medications to prepare for surgery.

Your child will need to have an empty stomach before the procedure. Ask the doctor when your child will need to stop eating.

Anesthesia

General anesthesia
is used during surgery. This will keep your child asleep and block any pain.

Description of Procedure

This is usually done in an outpatient setting. Your child will not need to stay in the hospital overnight.

Your child will be prepared for surgery. IVs will be placed in his arms for medications and fluids. Several techniques may be used to reconstruct the urethra. The doctor will attempt to use existing urethral tissue to:

Divert the tube to the correct position

Widen the tube if needed

Tissue may be taken from the foreskin or mouth to reconstruct the urethra. Incisions and graft procedures may also be needed to loosen certain areas of tissue to straighten the penis or correct other problems. A temporary catheter or stent may be placed in the penis for up to 2 weeks. This will allow your child to urinate. Bandages will be placed around the penis.

More complex cases may require a two-stage surgery approach.

How Long Will It Take?

1½ to 3 hours

How Much Will It Hurt?

Your child will be asleep during surgery. He will not feel any pain. After the procedure, the doctor will give your child pain medication.

Post-procedure Care

At the Care Center

The staff will provide care to make your child more comfortable and promote recovery. Pain medications and antibiotics may be given. Swelling at the surgery area is normal.

During your stay, the hospital staff will take steps to reduce your child's chance of infection such as:

Washing their hands

Wearing gloves or masks

Keeping your child's incisions covered

There are also steps you can take to reduce your child's chances of infection such as:

Washing your hands and your child's hands often and reminding visitors and healthcare providers to do the same

Reminding your child's healthcare providers to wear gloves or masks

Not allowing others to touch your child's incisions

At Home

When your child returns home, do the following to help ensure a smooth recovery:

Encourage light, gentle play while the penis is healing.

Follow all of the doctor’s instructions.

Call Your Child’s Doctor

After arriving home, contact the doctor if your child has any of the following:

Pain that is not controlled with medication given

Redness, increased swelling, or tenderness in the penis

Signs of infection, including fever and chills

Nausea or vomiting

Inability to eat or drink

Difficulty urinating or cannot urinate

Catheter or stitches fall out

In case of an emergency, call for medical help right away.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.